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TRANSVERSE PERINEAL SUPPORT: A SURGICAL SOLUTION FOR PERINEAL DESCENT
Luca Manfrino^*, Claudio Missaglia, Francesco Palmieri, Cozzolino Sofia, Andrea Vignali, Pierpaolo Sileri
Colorectal surgery, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy

Transverse perineal support is a surgical procedure used for cases of perineal descent consisting in placing a mesh above the superficial perineal fascia. The patient is placed in the lithotomy position. The ischial tuberosities are identified, and two incisions of 4 cm are made. Dissection of the subcutaneous tissue is performed until the periosteum is identified. A subcutaneous tunnel is created in the space between the anus and the vagina. The polypropylene mesh is then cut according to a pre-shaped template measuring 12 by 4 cm. The mesh is positioned and fixed to the periosteum of the ischial tuberosities using an endostitch. Once the mesh is fixed, the skin incisions are closed.

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